Changes in the general population, new technology for tests and interventions and rising public expectations have combined to add pressure on resources in health and social services. As far as health services are concerned, Gray (1996) suggests that clinical decision making is now one of the most important drivers of costs, making it imperative that decisions are based on the best possible evidence. However, it is important to note that increased attention to evidence not only contributes to the efficient use of resources, it can also help bring about a culture in which managers and practitioners routinely seek improvements in their services. John Northfield examines how we can use this technology to achieve maximum effectiveness

IN THE FIELD OF learning disability, a recent conference in Milton Keynes (NHSE 1997) drew attention to the fact that service planning and practice lags behind what is known from published research. A key issue, therefore, is how to help managers and practitioners make the best use of the wealth of information.